Many stroke survivors experience feelings of anger, frustration, anxiety, sadness, fear, and hopelessness in varying degrees. These emotions are common with post-stroke depression, which affects more than a third of stroke survivors. According to the National Institutes of Health, post-stroke depression is underdiagnosed.
Depression can set in weeks, months, or even years after your stroke and can stop your progress of recovery and rehabilitation, impacting your quality of life. A combination of factors can lead to post-stroke depression. The sudden nature of stroke can have a life-changing impact. Also, the damage to your brain after a stroke, genetics, and social factors can also contribute to depression.
- Persistent sad, anxious or empty feelings
- Sleep disturbances
- Increase or decrease in appetite and eating patterns
- Feelings of helplessness, hopelessness, and/or worthlessness
- Social withdrawal
- Loss of interest in activities or hobbies
- Difficulty concentrating or remembering details
- Aches, pains, headaches and digestive problems that do not ease with treatment
- Suicidal thoughts
Caregivers, family members, friends, and co-workers can be very helpful in recognizing post-stroke depression symptoms and encouraging you to consult with a healthcare professional.
- Medication. Medications known as antidepressants are common treatments for post-stroke depression and may be prescribed by your psychiatrist, primary care doctor, or other physician. Antidepressant medications interact with chemicals in the brain called neurotransmitters to improve mood.
- Mental Health Therapy. Medication is often combined with mental health therapy provided by a psychologist, psychiatrist, social worker, or counselor.
- Cognitive behavioral therapy focuses on helping you identify thoughts and feelings that lead to undesirable behavior.
- Other Therapy. Sometimes post-stroke depression is fueled by other after effects of stroke, such as spasticity or aphasia. Physical or speech therapy can improve those conditions, and in turn help you with post-stroke depression.
- Communicate. Talk about your feelings, post-stroke issues, and concerns with your caregivers, family, and friends. Relationships may change after a stroke and it may take time to adjust to new roles.
- Improve nutrition. Foods rich in omega-3 fatty acids, folic acid, vitamin B, and complex carbohydrates can help improve mood and fight depression.
- Omega-3 fatty acids (fish, flaxseed, walnuts) promote brain health.
- Complex carbohydrates (brown rice, oatmeal and whole wheat) boost neurotransmitter chemicals in the brain that affect mood.
- Dark chocolate helps fight fatigue and reduce stress.
- A deficiency in folic acid (found in beans, oranges, and broccoli) is linked to depression; folic acid boosts neurotransmitters and promotes cognition.
- Vitamin B12 (eggs, milk, liver) increases energy and alertness.
- Attend a stroke support group. National Stroke Association’s Stroke Support Group Registry lists hundreds of support groups throughout the U.S.
- Set realistic goals and prioritize. Break up larger tasks or projects into smaller ones.
- Practice stress and anxiety management techniques. Deep breathing, squeezing a stress ball, guided imagery, aromatherapy, meditation, and taking a walk or journaling can be very helpful.
- Be patient with yourself and loved ones. Stroke can be traumatic and recovery takes time.
- Stay as active as possible. Adaptive equipment and aids such as canes, braces and walkers can help stroke survivors improve physical fitness. Walking, yoga, and swimming, are low-impact and promote recovery.
- Get out into the community. Volunteering for a cause you believe in, returning to work, taking cooking classes, or joining a club can be exciting.
- Minimize or eliminate alcohol consumption and smoking.